Basic Information
| Provider Information | |||||||||
| NPI: | 1396072278 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CONTEMPORARY THERAPEUTIC SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6525 BELCREST RD | ||||||||
| Address2: | STE G40 | ||||||||
| City: | HYATTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207822003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017798345 | ||||||||
| FaxNumber: | 3017798417 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 KENT AVE | ||||||||
| Address2: | STE B | ||||||||
| City: | LA PLATA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206463753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013929315 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2009 | ||||||||
| LastUpdateDate: | 11/12/2009 | ||||||||
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| AuthorizedOfficialLastName: | HOWDEN | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
| AuthorizedOfficialMiddleName: | WASHINGTON | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/CFO | ||||||||
| AuthorizedOfficialTelephone: | 3017798345 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CONTEMPORARY THERAPEUTIC SERVICES INC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | MD | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 690504800 | 05 | MD | MEDICAID |